Tuesday, October 2, 2012

ZIMBABWE: Aid conditional on accepting circumcision

October 1, 2012

Zimbabwe: Will Circumcision Change Behaviour or Reinforce Machismo?

By Rashweat Mukundu A mood of sober curiosity as dozens of men - young and old-waited for their turn on the surgical table in order to have their foreskins chopped off characterised Harare's Spilhaus Family Planning Centre.

Following research that found circumcision reduces the risk of HIV transmission by as much as 60%, a USAID-supported programme aims to circumcise two million Zimbabwean men by 2015. So far, 55 000 have undergone the procedure.

I volunteered to take part after I received an HIV test and the advice that circumcision helps to prevent HIV and many other diseases.

Before the short surgical operation, all participants are tested for HIV and AIDS and provided with counselling services. They also take part in an awareness discussion about the benefits of circumcision. The discussion appeared to ease the expressions of fear and concern present on most faces in the room.


Circumcision remains a polarising issue, especially between men and women. Many of my female friends realise the obvious health benefits, including a lower risk of HIV infection. For women especially, if their boyfriend or husband is circumcised it lessens the chance he will infect them with HIV should he stray outside the relationship. [DANGEROUSLY WRONG - It does no such thing.]


As a government policy, it appears circumcision is reluctantly promoted by some MPs because other health-related and donor-funded initiatives are tied to this programme.

[In a word, blackmail.]

And while the benefits of circumcision have been proven, the temptation of circumcised men to feel "protected" - and hence indulge in unsafe sexual practices - is a dangerous risk likely also increased because of this programme.

A few weeks into my healing process, I heard from a man I'd met at the clinic. He said his organ had healed and wanted to "test" it. He made it clear that he wanted to "test" the organ on a number of sexual partners to be sure the he is "ok."

This illustrates the false attitude among many sexually active circumcised men that circumcision gives them license to take part in multiple sexual liaisons. Messages about the benefits of circumcision do not seem fully integrated into HIV prevention campaigns in a way that underscores the point that even circumcised men are at risk of contracting and spreading the virus. As such, continued emphasis on condom use and, more importantly, the development, awareness and access to HIV preventive methods that give women power over their sexuality, is key. [Circumcising men reduces women's ability to demand condoms.]

Circumcision does not necessarily result in male sexual behaviour changes. For many macho men, it might as well be another trophy in the cabinet. Such men have not understood the message that it is but one method of HIV prevention - men still need to be faithful and use condoms.


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